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Abstract

This introduction to conjoined special issues of Contemporary Drug Problems and the journal of the Alcohol and Drugs History Society, the Social History of Alcohol and Drugs, began with a 2015 symposium at the Baldy Center for Law and Social Policy at the University at Buffalo (SUNY), organized by co-editors Nancy D. Campbell and David Herzberg. The symposium called for incorporating gender analysis into the rapidly developing scholarship on drug use, drug trade, drug science, drug treatment, and drug policy in the United States. The special issues showcase articles that are part of a vibrant body of historical, sociological, and anthropological scholarship that explores the differential effects of drug policy, focusing on how gender—in dynamic relationship to race, class, and sexuality—is integral to virtually every aspect of drug crises including (but not limited to) the relationship between drug policy, drug treatment, and the development of mass incarceration. Gender matters at every level from the intimate and highly personalized to the broad cultural and political forces that disparately apportion vulnerability within drug commerce and the U.S. prison–industrial complex.
Guest Editorial
Gender and Critical Drug Studies:
An Introduction and an Invitation
Nancy D. Campbell
1
and David Herzberg
2
Abstract
This introduction to conjoined special issues of Contemporary Drug Problems and Social History of
Alcohol and Drugs, the journal of the Alcohol and Drugs History Society, began with a 2015 symposium
at the Baldy Center for Law and Social Policy at the University at Buffalo (SUNY), organized by
co-editors Nancy D. Campbell and David Herzberg. The symposium called for incorporating gender
analysis into the rapidly developing scholarship on drug use, drug trade, drug science, drug treatment,
and drug policy in the United States. The special issues showcase articles that are part of a vibrant body
of historical, sociological, and anthropological scholarship that explores the differential effects of drug
policy, focusing on how gender—in dynamic relationship to race, class, and sexuality—is integral to
virtually every aspect of drug crises including (but not limited to) the relationship between drug policy,
drug treatment, and the development of mass incarceration. Gender matters at every level from the
intimate and highly personalized to the broad cultural and political forces that disparately apportion
vulnerability within drug commerce and the U.S. prison–industrial complex.
Keywords
gender, feminism, history, embodiment, women, social contexts
These conjoined special issues of Contemporary Drug Problems and Social History of Alcohol and
Drugs (see Appendix for table of contents) began with a 2015 symposium at the Baldy Center for Law
and Social Policy at the University at Buffalo (SUNY), organized by co-editors Nancy D. Campbell
and David Herzberg. The symposium called for incorporating gender analysis into the rapidly devel-
oping scholarship on drug use, drug trade, drug science, drug treatment, and drug policy in the United
States. Revitalized recently as part of a broader reckoning with the United States’ ongoing legacy of
racialized criminalization and mass incarceration, a vibrant body of historical, sociological, and
anthropological scholarship now explores the racial dimensions of drugs and crime in America (Alex-
ander, 2010; Lusanne, 1991; Mauer, 1999; Murch, 2015; Thompson, 2010). This work has contributed
1
Rensselaer Polytechnic Institute, Troy, NY, USA
2
University at Buffalo, The State University of New York, Buffalo, NY, USA
Received September 26, 2017. Accepted for publication October 01, 2017.
Corresponding Author:
Nancy D. Campbell, Rensselaer Polytechnic Institute, 110 8th St., Troy, NY 12180, USA.
Email: campbell@rpi.edu
Contemporary Drug Problems
2017, Vol. 44(4) 251-264
ªThe Author(s) 2017
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DOI: 10.1177/0091450917738075
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to a broad social and scholarly consensus that drug policy has reified American racial hierarchies,
justified punitive policing, and fueled a carceral turn with racially disparate effects on communities
inside and outside U.S. prisons and jails.
Gender has not been a central concern in this literature, yet it could and should be. Gender, in
dynamic relationship to race, class, and sexuality, is integral to virtually every aspect of drug crises
including (but not limited to) the relationship between drug policy and the development of mass
incarceration. Gender matters at every level from the intimate and highly personalized to the broad
cultural and political forces that disparately apportion vulnerability within drug commerce and the U.S.
prison–industrial complex. As Campbell’s early work (2000) demonstrated, for example, portraying
drugs and drug use as a threat to “maternal instinct” has been a reliable way to build support for
punitive drug policies, even as punitive drug policies harmed women differently (and often, less
visibly) than men. Such gender dynamics are both strengthened and occasionally obscured by their
complete entanglement with racial and class formations. It would be irresponsible (and indeed impos-
sible) to address gender “on its own,” as if it could be disconnected from other social structures and
their historical development (Paltrow, 2013). But the reverse is also true: Racial and class construc-
tions are built out of and evolve in dynamic engagement with gender. These special issues demonstrate
how gender analysis can contribute to the broad scholarly project of understanding the effects that
drugs have had in the United States, Mexico, the United Kingdom, and beyond.
Not every anthropological, historical, or sociological project dealing with drugs must be primarily
focused on gender. Yet, we believe, such scholarship can be strengthened by an engagement with
questions about the intertwined effects of gender, race, class, and ethnicity on the social order. In this
introduction (printed in both special issues), we offer tools for doing so: an introduction to the
theoretical basis for gender analysis, a practical explanation for how gender analysis fits into drug
scholarship, a how-to guide with productive questions for integrating gender analysis, and a (necessa-
rily incomplete but hopefully inspiring) survey of some important gaps in the literature where new
work is urgently needed.
Building a “Critical Drug Studies”
A source of strength in drug scholarship, but also an obstacle to an effort like ours, is its dispersal
across multiple disciplines and divergent areas of focus (e.g., race, commerce, medicine, science and
technology studies). The symposium confronted this divergence almost immediately, as participants
questioned our initial title (“Gender and the Drug War”), observing the many ways that the “war on
drugs” has become a war on drug users, eliding the agency of “combatants” and “collateral damage”
alike. War metaphors co-produce the very “wars” they seek to cease, constituting publics by con-
scripting them into combat in ways difficult to resist. A more capacious framing, the symposium
believed, would be “Gender and Critical Drug Studies,” which gestured toward the diverse array of
analytical tools developed by critical race scholars, especially those working in carceral studies and
those exploring social deprivation as a wellspring of addiction. These tools do not rely on taken-for-
granted categories (e.g., “addicts,” “drug pushers”) but rather investigate their social construction and
impact. This approach offers greater analytical purchase than simple war metaphors for discerning
patterns of social dislocation, mortality and morbidity, and marginalization that characterize drug use
and shape the lives and deaths of drug users.
The symposium’s notion of a critical drug studies attentive to gender as well as race, class, and other
analytics guided our editorial planning for these special issues. One goal was to integrate existing but
dispersed gender scholarship in ways that can encourage the kind of dialogic deepening that can only
come from sustained engagement. Toward this goal, we invited participants from a wide range of
disciplines, hoping to build connections and common intellectual frameworks that can provide a basis
for new scholarship. We thus sought scholars who practice a range of methodologies from ethnography
252 Contemporary Drug Problems 44(4)
to neuroscience and who engage with a range of sources including archives, oral histories, surveys, and
visual representations in mainstream media. A second goal was to build up the visibility of gender
analysis and make a case for its utility among those who produce drug scholarship including relative
newcomers to the study of gender and drugs as well as long-standing practitioners.
It is important to note, again, that paying meaningful attention to gender does not require reorienting
or redefining oneself as a gender scholar. While this kind of deep engagement is valuable, we believe
that everyone can adopt habits of mind that open rather than foreclose gender questions and make
visible the gender dichotomies that pervade our research material. How does gender shape outcomes,
and how can we develop research questions and methods to render those effects visible and analyz-
able? How do people’s actions reproduce, challenge, reify, or change gender assumptions, and how can
we design research to capture the way gender is the result, not just the cause, of the processes we study?
Critical Drug Studies Needs Gender
Drugs demand attention in gendered ways. Whether legal or illegal, controlled or beyond control,
drugs are gendered in their power to compel human action in popular culture, academic discourse,
medicine, and public health interventions alike. Gender structures lived experiences and relations
between the kinds of knowledge, imaginative connections, and practices that comprise drug experi-
ences—and the commercial, medical, and carceral acts that surround them. Taking inspiration from
scholars and activists who have made race an indispensable tool for analyzing the differential impacts
of U.S. drug policy, and hoping to contribute to that project, we contend that it is similarly impossible
to fully understand the effects of drugs on social orderings of all kinds without also paying attention to
gender analysis.
Scholarly and political engagement with “gender” has been rich, diverse, and often powered by
intense and productive disagreement. What, then, do we mean when we ask critical drug studies
scholars to engage with gender? In the broadest sense, we begin with the proposition that gender is
relational, not categorical. The bodies, identities, practices, and ideas associated with gender do not
occur naturally but are actively produced and reproduced socially in dynamic tension with historical
circumstances and relational inequalities. They change over time in response to human action and
struggle. Because gender categories are accomplished products rather than premises or prescriptions,
their meanings must be interpreted and explained rather than deployed as simple demographic units.
Yet, gender “works” by appearing to be just the opposite—by appearing to represent a natural set of
binaries. How to reconcile gender’s continually evolving complexities with the misleading simplicity
that Sociologist R. W. Connell (2002) calls the “familiar dichotomy of male and female bodies” is a
central challenge and opportunity for scholars.
Seeing gender as relational requires asking how and why the “familiar dichotomy” and its associ-
ated cultural formations keep getting mapped on to bodies, practices, political narratives, policies,
markets, and institutional responses. For instance, one of the central canards of 20th-century U.S.-style
drug policy has been to distinguish between active, masculinized “pushers” with whom to “get tough”
and passive, feminized “users” or “addicts” in need of “rehabilitation” (Kohler-Hausmann, 2010;
McCorkel, 2013). Whole policy regimes dedicated to negating cross-fertilization between the two
have been predicated on this gendered dichotomy. Yet, a relational approach immediately raises
skepticism about such a divide. Classic works such as Edward Preble and John Casey’s “Taking Care
of Business” showed that, in practice, there was no clear separation between drug users and traffickers
and, moreover, that users were far from passive, actively “hustling” to maintain “the life,” an insight
that remains relevant (Dunlap, Johnson, & Manwar, 1994; Dunlap & Johnson, 1996; Sales & Murphy,
2007). Later scholars such as Elaine Carey further debunked the gendered pusher/addict dichotomy by
showing that women drug traffickers brought specific skills to bear in ways affected the configuration
and evolution of illicit markets.
1
Campbell and Herzberg 253
The misleading ubiquity of gender binaries in primary materials bedevils empirical researchers.
Gender is a continual performative enactment of what Hacking (1999) calls a “looping kind,” in which
what people do is affected by the categories to which they are assigned. People’s actions are shaped by
subjective awareness of gender positioning as well as by the opportunities and constraints that are
produced by the way gender structures their social, cultural, and political milieu. Thus, while gender is
socially produced, its effects are so real that research subjects often identify themselves through
gender’s “familiar dichotomy” and their lives are structured by this identification. We cannot simply
ignore their own conceptions of themselves—it would be disrespectful as well as erroneous. Instead,
the challenge is to acknowledge and explore those effects and identifications without reifying them or
casting them as timeless truths. In other words, we explore how gender structures the fields within
which people interact, while simultaneously thinking about how those interactions also reproduce or
challenge gender categories.
Gender’s effects are not (only) felt at an individual level. Gender categories also support, and are
supported by, a coherent system of institutionalized divisions of affect, labor, and leisure constitut-
ing what sociologists call a “gender order” (Connell, 2002, p. 53). Gender orders are constantly
brought to crisis, and their legitimacy questioned in ways that produce new gendered patterns of
opportunities and constraints. Drugs have often played important roles in this continual process
because they are an important resource for identity production in interaction with other changes in
social order. Think, for example, of how women’s smoking or drinking have been used as evidence
of—and to characterize—unwanted social change. “Drugs” themselves, in other words, are a com-
plex cultural accomplishment: a misleadingly coherent set of ideas, practices, and objects that can be
deployed to build socially and political significant identities. At the most basic level, the category of
“drugs” makes sense only through processes of social ordering that assign substances to particular
classes and legal statuses—perhaps most importantly, “medicinal” and “nonmedicinal.” These cate-
gories interact with an endless range of potential identities, from basic categories such as “addict” or
“overdose” to more complexly positioned ones such as “stable user,” “in recovery,” or “drug naive,”
all continually proliferating into a broad array of emergent gendered practices. In this context,
gender, like race and class, interacts with a range of other categories formed from drugs’ supposed
powers to create, threaten, supplant, destroy—or, alternatively in the case of legal pharmaceuticals,
consolidate and shore up—identities.
Gender is but one of the intersecting categories to which bodies are assigned that make them
appear to be natural expressions of social orders with which they are entangled. Thus, for
example, skin hue or hair texture become evidence of race, ethnicity, and associated construc-
tions; muscle and fat distribution become evidence of gender; and so forth. In this way, people
navigating social forces like race and gender come to seem, through their bodies, as the sources
of and justification for those forces. Bodies thus become “interpretable” culturally and politically
and in response are themselves changed. Bodies are not natural material upon which cultural
edifices are built but are instead shaped to carry the effects of a gender order. Our focus on
gender in these special issues does not suggest that gender is more fundamental than other
categories. Rather, it is a recognition of the intense interpretability of all categories to which
bodies are assigned for economic and political purposes.
A Schematic Literature Review of Gender and Critical Drug Studies
Over the past 20 years, drug scholarship has arisen in many different fields, making it possible to
imagine a vibrant multidisciplinary project of critical drug studies. We make no attempt to exhaus-
tively trace the genealogy of gendered categories, social processes, and divisions of labor here but
instead highlight the boundaries of an emerging field of inquiry with an eye toward emphasizing those
contexts that help situate the works of the editors and contributors to these special issues.
254 Contemporary Drug Problems 44(4)
Some of the earliest gender scholarship was introduced by feminist drug ethnographies such as
Rosenbaum’s Women on Heroin (1981) and sociological work such as Ettorre’s Women and Substance
Use (1992), which paved the way for a flourishing of feminist studies in the 1990s and 2000s. Although
much of this work focused women’s experiences of heroin in the United States and the United
Kingdom, the expansion of research on drug-using women in the 1990s occurred amid highly politi-
cized concern about maternal crack cocaine use, which shaped U.S. drug policy as a gendered regime
to a greater degree than policy elsewhere. Ethnographers, for example, investigated conditions of
“sexed work” in informal economies (Dunlap, Johnson, & Maher, 1997; Maher, 1997; Maher, Dunlap,
Johnson, & Hamis, 1996; Maloney, Hunt, & Joe-Laidler, 2015; Sales & Murphy, 2007). Relying not on
onetime interviews or “rapid ethnographic assessment” (Inciardi, Lockwood, and Pottieger, 1993;
Surratt, Inciardi, Kurtz, & Kiley, 2004), Maher (1997) and Maher, Dunlap, Johnson, and Hamis
(1996) provided extensive ethnographies of women’s participation in neighborhood-level informal
economies (see also Mieczkowski, 1994; Sterk, 1999). Reviewing these empirical studies, Maher and
Hudson (2007) identified the following findings on women’s participation in drug economies largely
in English-speaking countries:
1. The drug economy is gender-stratified and hierarchical,
2. women primarily access and sustain roles in the drug economy through links with men,
3. female roles in the drug economy have a sexualized quality,
4. family/kinship ties are important resources for women dealers, and successful women dealers
appear to have increased social capital,
5. “feminine” attributes and institutional sexism can work to women’s advantage, and
6. women are diversifiers and able to juggle different roles both within the drug economy and in
relation to dealing and domestic responsibilities.
They identified a cyclic phenomenon in which new drug markets seem initially to open opportu-
nities for women, which are quickly foreclosed as they are once again relegated to gender-stratified
work that constrains their agency within a gendered social order.
The flourishing gender scholarship also had an impact on drug history, where foundational works,
such as The American Disease: Origins of Narcotics Control Policy (1973) by David F. Musto, and
Dark Paradise: A History of Opiate Addiction in America (1982) by David T. Courtwright, addressed
gender but did not explicitly explore its impact (in part because they were published before the
conceptual apparatus for doing so had been fully developed). Campbell (2000)’s Using Women:
Gender, Drug Policy, and Social Justice, drawing on early feminist ethnographies, public documents,
and transcripts of congressional hearings, examined the “governing mentalities” of gendered discourse
on drugs. Campbell documented moments when drug-using women were called to account for trans-
gressing gendered and racialized obligations of biosocial reproduction—for not playing their “proper”
gendered roles. Spanning much of the 20th century, Using Women showed how expert knowledge,
popular culture, and drug policy were produced recursively in conversation with gender, race, class,
and sexuality as salient symbolic values and material constraints. Ultimately, Campbell argued that
gender became meaningful for every level of drug policy-making, helping to transform ideological
decisions into seemingly unquestionable reflections of an ostensibly natural gender order. Crises of
social reproduction were projected onto drug-using women who were themselves used in policy-
making domains to assert, justify, or claim cultural crisis. Although representations of drug-using
women encoded the “governing mentalities [that] guide the realist and rationalist discourses through
which policy-makers approach their work,” her discursive history demonstrated how a gendered and
racialized state produced injustice by amplifying and reproducing vulnerability and criminality both
culturally and structurally. The tie between governance and knowledge production was clearest in
moments, when women’s drug use was used to “figure” crisis in biosocial reproduction. This
Campbell and Herzberg 255
theoretical orientation and the critical historiography on which it was based contrasted to classic works
in drug policy history.
One vein of sociological and anthropological examinations of gender and drugs explored the
systematic repression of women (and, to some extent, nonconforming men—see Bourgois, 1995,
which examines drug-using “vulnerable fathers” whose “paternal powerlessness” was often expressed
via reassertion of patriarchal logics that have been widely repudiated and structurally disrupted).
Kandall’s Substance and Shadow: Women and Addiction in the United States (1996), for example,
surveyed the “range of indignities” visited upon drug-using and addicted U.S. women across the 20th
century (p. 285). Such work is valuable but also risked reifying gender binaries by defining its poles as
the presence or absence of power or capacity to exercise agency. More recent qualitative drug research
exposes and explores the complexities encountered in negotiating gendered contexts. Anderson,
building on an older critique of “jailhouse sociology” of “captured populations,” sought in Neither
Villain nor Victim: Empowerment and Agency among Women Substance Abusers (2008) to move
beyond perspectives grounded in “pathology and powerlessness” that accentuated drug-using women’s
deviance and dysfunction and instead to recognize drug users’ and sellers’ agency, abilities, and stakes
in conventional life. Taking up this “empowerment” perspective, Anderson (2005) studied drug users
who were not located via treatment or carceral institutions. The international research community, too,
has moved increasingly toward studying drug users using nonopioids in recreational contexts, partic-
ularly in Australia, Europe, and the United Kingdom (Aldridge, Measham, & Williams, 2011; Parker,
Aldridge, & Measham, 1998; Race, 2009). New emphases on pleasure and users’ capacities to shape
their experiences within queer communities and leisure settings have emerged as drug studies becomes
more critical.
One area of particularly deep engagement has been drug-using pregnant and parenting
women—in part because “reproductive regimes” (Ettore, 2010) have played such an important
semiotic and practical role in drug politics. As Knight (2015) shows in addicted.pregnant.poor,
pregnancy is both a time when women’s rights and freedoms are denied but also when basic
needs for social support and health care become “legitimate and visible” (p. 215). In From
Witches to Crack Moms (2015), Boyd documented how experiences and representations of
drug-using women in the U.S., Canada, the UK, and Colombia both reflect and reproduce
gendered assumptions. The regulation of drug-using women, she argued, particularly those preg-
nant or parenting, occurs via formal laws and policies, but also the far less formal social controls
to which they are subjected in everyday life (1994, 1999, 2015). Such critical scholarship on
drug-using pregnant and parenting women has emerged in tandem with political campaigns to
shift international and domestic drug policy, as the United Nations, Open Society Foundation,
Amnesty International, and National Advocates for Pregnant Women (NAPW) consistently place
evidence of gender-based civil and human rights violations of drug-using pregnant and parenting
women before international governing bodies (Malinowska-Sempruch & Rychkova, 2015;
National Advocates for Pregnant Women, 2017; Paltrow, 2013; Paltrow & Flavin, 2013).
Gender dynamics are not restricted to illicit drugs; they also operate in the context of legal phar-
maceuticals, as Herzberg showed in Happy Pills in America (2009). Herzberg found, for example, that
tranquilizer-using “anxious businessmen” were stock characters in 1950s campaigns to reinstate
normative gender roles after the disruptions of depression and war, and tranquilizer-using “addicted
housewives” were similarly common characters in 1970s feminist campaigns to politicize the miseries
of domesticity. Happy Pills argued that these 1970s campaigns succeeded in part by repurposing the
already-ubiquitous vocabulary and iconography of drug advertising and thus often reified the race and
class scaffolding of complex cultural artifacts such as “anxiety” and “addiction.” This limited their
political reach and left them vulnerable to socially exclusive “solutions” such as the 1990s wonder-
drug Prozac, which were celebrated amid an antifeminist backlash as a way to empower individual
white-collar women without feminism or collective action.
256 Contemporary Drug Problems 44(4)
Historians such as Metzl (2011, 2003) and Hirshbein (2015, 2009) have explored the role of gender
in American psychiatry’s increasing engagement with psychoactive pharmaceuticals. For Metzl
(2003), psychiatric drugs served as a magician’s apprentice, initially embraced as a tool for demon-
strating the profession’s masculine mastery over troublesome women, but eventually imprisoning the
profession itself in the cultural logics the drugs had come to embody. Hirshbein (2009) tracked a
recursive research loop that contributed to women being the main consumers of antidepressants.
Depression, she argued, was defined through studies of women whose suffering responded to anti-
depressants; depression scales and checklists thus circularly demonstrated antidepressant effectiveness
and selected for symptoms marked as feminine in American culture. McClellan (2017) and Rotskoff
(2003), building on the rich literature on gender and 19th-century Temperance crusades, explored how
cultural struggles over masculinity and femininity shaped categories of acceptable, abusive, and
“alcoholic” drinking and treatment. Marez (2004) examined how racialized constructions of Mexican
women as needing the protection of White male police helped sexualize and sensationalize an effort to
combat Mexican immigrant labor radicalism by criminalizing Mexican men as marijuana traffickers.
Comparing women’s rehab programs both inside and outside of the criminal justice system, McKim
(2017) identified racial differentials in the very definition of addiction, pathways into rehab, funding
sources, and institutional commitments.
The gendered interplay between drugs designated as legal and those designated illegal is no mere
academic debate. This “familiar dichotomy” shapes national and international drug policy regimes and
their immediate and long-term shaping effects. Work in political science, studies of law and society,
and anthropology, history, and sociology of medicine traces oscillation between “medicalization,”
often directed toward members of the so-called dominant classes such as White women or youth, and
“criminalization,” often directed toward the so-called dangerous classes such as racial minorities or the
poor. Major social processes structure the drugs field, yet remain generalizations because the con-
tinuum between medicalization and criminalization has not operated in mutually exclusive ways, even
in regimes founded upon prohibition (Campbell, 1995; Fraser & Moore, 2011; Netherland, 2012;
Kohler-Hausmann, 2010; Schneider, 2008). Similar to policy toward “unwed mothers” (Solinger,
1992), this regulatory continuum operates as a palimpsest for racial ordering: medicalization regulated
primarily White people through clinical practice, positioning communities of color to absorb the brunt
of criminalization (Herzberg, 2017). While it is useful to understand how these social processes are
gendered or racialized, actual interactions reveal considerable divergence and leakage between cate-
gories, particularly within the historical and cultural contexts of lived experience.
In these Special Issues
Contributors to the special issues build on many aspects of this multidisciplinary empirical, theoretical,
and methodological literature. Several expand on empirical findings emphasizing that women’s roles
and experiences do not fit into simple gender binaries. Carey’s article on Mexican women drug
traffickers suggests that American drug economies included a wider range of more durable openings
for women—women’s participation was not limited to serving as “mules” and low-level actors in a
highly masculine domain, but rather, women were drug entrepreneurs whose shrewd profit-seeking,
protected by the cover of gendered familialism, led to cartel formation and new domestic drug markets
in Mexico. Natasha Du Rose offers a similar rethinking of women drug users, insisting on their
“pleasure and agency” rather than only seeing their constraints and victimization. Spillane’s article,
meanwhile, uses The Fantastic Lodge, a life history based on Sociologist Howard Becker’s interviews
with a woman heroin user, to explore how gender structured relational networks of heroin users in
post–World War II Chicago—both through external opportunities and constraints and through sub-
jective gendered awareness. Muehlmann approaches similar questions from a different vantage point,
examining not drug traffickers or drug users, but Mexican women activists whose gender positioning
Campbell and Herzberg 257
as mothers, rather than being a source of limits and lack of agency, became tools from which they built
a powerful political stance against the “drug war.”
A number of contributors work further on questions of gendered knowledge production and
social drug governance. By focusing on the importance of anxiety and benzodiazepine use to
women’s overdoses during the early 21st-century opioid “epidemic,” for example, Kelly Knight
reveals gender-specific burdens and constraints that adhere differently to women based on their
social locations in racialized and classed hierarchies. She traces how structural forces are elided
in opioid discourses, thus erasing the uneven opportunities for more privileged women drug users
to appeal to “empathy” rather than stigma and punishment in the context of pregnancy and
parenting. Helena Hansen’s ethnography of “wasted whiteness” takes Staten Island as a site for
analyzing the production of the U.S. opioid “epidemic” as “White” and for depicting presump-
tively innocent, middle-class White women as prominent symbols of the crisis. Such cultural
politics, she argues, obscure the historical impact of opioids on communities of color and encour-
age a racially and class-disparate policy of supportive treatment as opposed to the punishment
directed toward other categories of drug users. Helen Keane demonstrates that expert medical
discourses about addiction, even those located “in the brain” and implicitly or explicitly claimed
as nongendered, recapitulate familiar, gender-specific stories of vulnerability and risk that dis-
parately position women drug users as more deviant and thus more difficult to “treat.” Jill
McCorkel looks at how the gendered positioning of women’s prisons made them an ideal entry-
way for organized efforts to “profit from the poor” by monetizing addiction rehabilitation both
within and after release from prison. And Trysh Travis examines a 1960s/1970s effort by
women’s center to reimagine addiction treatment along explicitly feminist lines, finding in the
endeavor both a politically aware path not taken and an example of the limits and risks of using
gender categories (e.g., “women”) in reworking political structures.
Finally, several contributors address the complexity of attempting to step outside of gender from the
researcher’s point of view. Michelle McClellan, Community Psychologist Beth Glover Reed, and
Neuroscientist Jill Becker tell the story of a feminist collaboration that seeks to bridge the commu-
nicative chasm between various “ways of knowing” gender and sex differences in the addictions field
including some of the very “female vulnerabilities” noted in Helen Keane’s article on the gendered
effects of seemingly gender-neutral models of the role of the brain and brain disease. In doing so, it
attempts to confront what Campbell and Ettorre (2011) have described as amnesiac reinventions of the
wheel at work in programmatic calls to address the absence or invisibility of women’s agency in drug
science, treatment, and research. Ettorre’s article for these special issues uses feminist auto-
ethnography to explore her own pioneering research on women drug users and to demonstrate the
value for researchers of recognizing their own gender positioning as they seek to understand the
experiences of others.
Seeing Gender in Critical Drug Studies: A How-to Guide
One of the first steps for practicing gender analysis in critical drug studies is to develop the habit of
looking for it. This can be difficult because gendered logic often works by virtue of what it makes
invisible—for example, supposedly universal models of addiction that are in fact based on the experi-
ences of men. Thus, one of the first steps in making gender visible, more often than not, is to simply
ask: Where are the women, and what are their lived experiences? There are risks to this approach—
notably, the risk of accepting the category of “women” as a premise rather than a consequence and the
risk of homogenizing “women” rather than acknowledging gender’s intersectional relationship with
race and other social categories. Yet, it is a powerful way to reveal gendered “truths” about drugs,
which often depend on obscuring or mischaracterizing women’s experiences. Some of these “truths”
may have been internalized by drug-using women themselves, and research cannot ignore this
258 Contemporary Drug Problems 44(4)
consequential reality. Yet, incorporating a gender analysis—in other words, seeing those “truths” as
achieved rather than given—does more than simply adding women to a stable existing story; instead, it
radically changes that overall story, allowing new temporalities and geographies to emerge. Thus, one
of the first things that a gendered critical drug studies can do is to follow the examples of feminist
activists (including drug treatment providers, physicians, and researchers) in widening the lens of the
story away from (presumed male) drug users and (presumed male) police and scientific experts and
toward new characters, especially women.
The most obvious set of characters are women drug users. Continually constructed as a “hidden
population,” women drug users are often thought to be reachable only via special efforts. They have
been remarginalized even as they were “rediscovered,” yet again, to comprise a significant proportion
of users in need of gender-specific help. In calling for new attention to their experiences, we are
definitely not calling for new gender stereotypes to replace those we have collectively worked hard to
displace. We call instead for gender to be recognized as one among many differences that shape drug
experiences and their consequences. Drug scholars should recognize that women move in and out of
roles in response to opportunities, problems, and intentions; their standpoints are neither more nor less
“authentic” than those of others in the situation. Indeed, women drug users are not the only group made
invisible by gendered logic. Like our special issue contributors, drug scholars can also look beyond
gendered assumptions to find women in a wide range of other roles: as producers of “expert” knowl-
edge outside of privileged masculine spaces, as drug entrepreneurs, as political activists, and as
cultural mediators.
In addition to studying these women and others who have been “hidden from history,” drug
scholars can question the practices and contexts that produce gendered patterns of visibility and
invisibility. There are contexts where gender is salient, and there are contexts where it is not;
contexts where gender is made invisible, and contexts where it is made hypervisible. Along with
analyzing the dehumanizing and depersonalizing rhetorics of “dealers” versus “users,” of mon-
strous or abject, of anguish, suffering, and disempowerment—all of which serve to obscure
women’s agency—we direct attention to women’s pleasure, relief from suffering, and empower-
ment. We must attend to how gender is deployed discursively not only by cultural authorities but
also by women themselves who are seeking to maximize their own economic and political
agendas.
This calls for creative approaches to finding evidence. Archives for gender and critical drug
studies are not abundant. Scholars must be alert to spaces in which evidence of gendered
activities have occurred in the past, or are occurring in the present, as these may not be
accessible in the future. All of the scholars who comprise these special issues, as well as those
of the formative generations of this type of work, have consistently had to engage in the
formation of what we might call “archives of one’s own.” How else would they become aware
of, and track, dynamic interactions between lived experiences and gendered discourses that
produce change over time?
It is important to remember that gender is not static and binary but rather dynamic, changing, and
continually challenging. Many of the categories through which we are invited to think about drugs
implicitly or explicitly rest on gendered binaries: crime versus disease, treatment versus punishment,
abstinence versus maintenance, medicine versus “drug,” victim versus agent, pleasure versus suf-
fering, and so on. Drug scholars can steer clear of such homogenizing categories, including those of
“women” or “mothers” or “intravenous drug users” (Szott, 2015), even when those categories were
advanced for the compassionate purpose of destigmatizing addiction. This can be particularly help-
ful in analyzing recent expert knowledge production such as the National Institute on Drug Abuse
(NIDA) paradigm that assumes either a “universal” stance based on androcentric models or an
“essentialized” approach based in binary oppositions between masculine and feminine. Such gen-
dered dichotomies are particularly prevalent in discourse on pregnant or parenting women whose
Campbell and Herzberg 259
drug use signals their lack of fitness for motherhood and plays into the denials of personhood
(Campbell, 2000; Knight, 2015; Roberts, 1997).
Work That Needs Doing
There is so much left to do that we cannot hope to enumerate it all here. Yet, it is worth briefly
reflecting on those gaps that we believe are most critical as an open invitation to all scholars and
activists who take up critical drug studies.
We need gendered investigations of a wider array of persons, locations, and experiences; we
especially need more work on how legal pharmaceutical use is intersectionally gendered and
racialized.
We need gendered investigations of a wider array of psychoactive substances including alcohol,
tobacco, cannabis, antidepressants, ecstasy, hallucinogens, ketamine, coffee/tea, khat, coca leaf,
and NPMs, both in the present and historically.
We need to move beyond analyzing pharmaceutical advertising to analyzing gender in phar-
maceutical workplaces and pharmaceutical commerce more generally: from research labs to
production lines to “pharma babe” sales representatives and “pharma bro” CEOs, to ancillary
enterprises such as Damien Hirst’s artistic pursuits and restaurant designs, and to fashion lines
such as Moschino’s 2017 capsule collection (Atluru, 2017).
We need gendered ethnographies into the experiences of consumers of psychoactive pharma-
ceuticals, both licit and illicit.
We need gendered investigations (ethnographic and otherwise) of the social practices of drug
policing through both the criminal justice system and biopolitically under the aegis of “medical”
regulation. In particular, we need gendered analyses of the development and practices of drug
expertise (research and treatment) and its intersection with drug users (especially in the multi-
farious forms of “rehab,” both within and outside of prisons)—including not only the experience
of women drug users as subjects of research and treatment but also women as producers of
expertise and expert knowledge.
We need gendered investigations of drugs and sexuality, sex work, and transgender issues.
We need gendered investigations of men’s experiences as men, analyzing how masculinity
operates in relation to drug use, drug markets, and drug policies. However, this work should
follow, not precede, badly needed work focusing on women because men’s roles—often mis-
interpreted as universal—have received substantial and sustained attention.
Finally, and crucially, we need investigations into the gendered dimensions of transnational
drug use, drug commerce, drug policy, and drug policing. U.S.-focused gender scholarship must
become more attentive to the transnational turn.
Gender is a multiply signified social difference that is performed or “enacted” in ways that have
become associated with a vast cultural repository of ideas and attitudes about drugs, a series of
enactments that are continually reconfigured through policy and practice. Because they are relational
and not categorical, and co-produced rather than constituted a priori, gender formations are implicated
in doing drugs and in the domains of drug policy, science, treatment, and policing. The articles in these
special issues examine the complex relationship between people’s actions, expectations, and experi-
ences regarding gender and drugs and the often binary analytic categories, ideal types, and enduring
tropes that are applied to them. They thus point toward seeing gender as dynamic, relational, and
dimensionally enacted rather than as binary and static. They evoke the vibrant approach we seek to
cultivate in critical drug studies.
260 Contemporary Drug Problems 44(4)
Appendix
Acknowledgments
The editors wish to thank the Baldy Center for Law and Social Policy at the University at Buffalo
(State University of New York), which funded and hosted the original symposium from which these
special issues grew.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or
publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this
article.
Note
1. Similar to wives in Boydston’s Home and Work and slaves in Baptist’s The Half Has Never Been Told.
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Author Biographies
Nancy D. Campbell is a professor of science and technology studies at Rensselaer Polytechnic Institute in Troy,
New York. She currently studies overdose prevention as a social movement linking harm reduction, health care,
and human rights. With Elizabeth Ettorre, she co-authored Gendering Addiction: The Politics of Drug Treatment
in a Neurochemical World (Palgrave, 2011). Her first book was Using Women: Gender, Drug Policy, and Social
Justice (Routledge, 2000). She is an author of Discovering Addiction: The Science and Politics of Substance
Abuse Research (2007) and a co-author with J. P. Olsen and Luke Walden of The Narcotic Farm: America’s First
Prison for Drug Addicts (2008).
David Herzberg is an associate professor of history at the University at Buffalo (SUNY). He is a cultural historian
whose work specializes in how encounters with health and illness have been transformed in the 20th century’s
consumer culture, particularly in the context of psychoactive pharmaceuticals. His work has appeared in American
Quarterly,American Journal of Public Health,Atlantic Monthly Online, and his first book is Happy Pills in
America: From Milltown to Prozac (Johns Hopkins, 2009). He is currently writing a second book tentatively titled
The Other Drug War: A History of Psychoactive Pharmaceuticals and Addiction in America.
264 Contemporary Drug Problems 44(4)
... [8][9][10][11] Women (inclusive of gender-diverse persons) who use drugs are disproportionately affected by social violence, which shapes health, overdose risk, and access to and uptake of overdose prevention interventions. [10][11][12][13][14] They are subject to gendered patterns of interpersonal violence (e.g., intimate partner violence) 15 and state violence (e.g., punitive sex-work and drug laws, regulation of reproduction and mothering) 13,16,17 compounded by intersecting systems of oppression (e.g., White supremacy, capitalism). In Canada, colonialism begat systemic social and legal discrimination resulting in the forced removal of Indigenous children from their homes (residential schools, child apprehension) and an alarming epidemic of racialized, gendered violence (including homicide) among Indigenous women and girls. ...
... [8][9][10][11] Women (inclusive of gender-diverse persons) who use drugs are disproportionately affected by social violence, which shapes health, overdose risk, and access to and uptake of overdose prevention interventions. [10][11][12][13][14] They are subject to gendered patterns of interpersonal violence (e.g., intimate partner violence) 15 and state violence (e.g., punitive sex-work and drug laws, regulation of reproduction and mothering) 13,16,17 compounded by intersecting systems of oppression (e.g., White supremacy, capitalism). In Canada, colonialism begat systemic social and legal discrimination resulting in the forced removal of Indigenous children from their homes (residential schools, child apprehension) and an alarming epidemic of racialized, gendered violence (including homicide) among Indigenous women and girls. ...
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This article rethinks the formative decades of American drug wars through a social history of addiction to pharmaceutical narcotics, sedatives, and stimulants in the first half of the twentieth century. It argues, first, that addiction to pharmaceutical drugs is no recent aberration; it has historically been more extensive than “street” or illicit drug use. Second, it argues that access to psychoactive pharmaceuticals was a problematic social entitlement constructed as distinctively medical amid the racialized reforms of the Progressive Era. The resulting drug control regime provided inadequate consumer protection for some (through the FDA), and overly punitive policing for others (through the FBN). Instead of seeing these as two separate stories—one a liberal triumph and the other a repressive scourge—both should be understood as part of the broader establishment of a consumer market for drugs segregated by class and race like other consumer markets developed in the era of Progressivism and Jim Crow.
Book
After decades of the American "war on drugs" and relentless prison expansion, political officials are finally challenging mass incarceration. Many point to an apparently promising solution to reduce the prison population: addiction treatment. In Addicted to Rehab, Bard College sociologist Allison McKim gives an in-depth and innovative ethnographic account of two such rehab programs for women, one located in the criminal justice system and one located in the private healthcare system-two very different ways of defining and treating addiction. McKim's book shows how addiction rehab reflects the race, class, and gender politics of the punitive turn. As a result, addiction has become a racialized category that has reorganized the link between punishment and welfare provision. While reformers hope that treatment will offer an alternative to punishment and help women, McKim argues that the framework of addiction further stigmatizes criminalized women and undermines our capacity to challenge gendered subordination. Her study ultimately reveals a two-tiered system, bifurcated by race and class.
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